Obamacare, Aleppo And Coal: The Second Debate Had Substance, Too

For a while during Sunday night’s presidential debate, it seemed like policy issues might never come up at all. Most of the first half-hour was dedicated to various scandals: Bill Clinton’s infidelities, Hillary Clinton’s emails and, of course, the now-infamous Donald Trump video that had dominated headlines for the previous 48 hours. It was nearly 9:30 p.m. before we got the first question on a real policy issue. (The debate started at 9 p.m. eastern.)

The final hour of the debate, however, featured some reasonably substantive discussions on a range of issues including taxes, gun control and foreign policy. The candidates also delved into some subjects that didn’t get much attention in the first debate, such as energy and health care. Somewhat surprisingly, however, there was once again very little discussion of immigration (apart from one exchange about Muslim immigration and terrorism). There was also significantly less discussion of trade this time than last, although Trump did manage to repeat his (dubious) claim that NAFTA was the worst trade deal “in the history of the world.”

For the full rundown of what the candidates discussed, check out our live blog. But here are a few highlights from the major policy debates of the evening.

Health care

Clinton: “If we were to start all over again, we might come up with a different system. But we have an employer-based system. That’s where the vast majority of people get their health care. And the Affordable Care Act was meant to try to fill the gap … 20 million people now have health insurance. So, if we just rip it up and throw it away, what Donald’s not telling you is, we just turn it back to the insurance companies, the way it used to be.”

Trump: “Obamacare is a disaster. You know it, we all know it. … Their method of fixing it is to go back and ask Congress for more money. More and more money. … We have to repeal it and replace it with something absolutely much less expensive, and something that works.”

The debate over Obamacare — much like the American health care system itself — is far too complicated to cover in a few paragraphs. But at the most basic level, here is where the U.S. health insurance system stands six years after the passage of President Obama’s signature health law: The Affordable Care Act largely succeeded in its goal of bringing health insurance to millions of Americans who didn’t previously have it (although 29 million Americans remain uninsured). But it has not yet succeeded in bringing down health care spending overall, or in ensuring that all Americans can afford to seek medical care.

Clinton’s approach was to acknowledge those problems and pledge to address them while simultaneously reminding voters about parts of the law that they actually like. The law prohibits insurance companies from denying coverage to patients with pre-existing conditions, for example, and allows young adults up to age 26 to stay on their parents’ insurance plans. The American health care system isn’t perfect, Clinton acknowledged — at one point, she said, “If we were to start all over again, we might come up with a different system” — but like most Democrats, she believes it makes more sense to fix it than to start over.

Trump, by contrast, said Obamacare is beyond fixing and should be fully repealed. (On our live blog, our in-house health care expert Anna Maria Barry-Jester questioned whether that’s even possible at this point.) The Republican nominee vowed to replace the ACA with a better system but provided few details on what that might be. The one specific proposal he did make was to “get rid of the … artificial state lines where we stop insurance companies from coming in and competing.” That is a reference to a longtime Republican proposal to allow companies to sell insurance across state lines, boosting competition and, in theory, lowering cost. But as Margot Sanger-Katz wrote in The New York Times last year, the real barrier to interstate insurance sales isn’t regulation but rather the difficulty of setting up hospital networks in new areas.

Taxes

Trump: “She complains that Donald Trump took advantage of the tax code. … Why didn’t you change it when you were a senator? The reason you didn’t is that all your friends take the same advantage that I do. And I do. You have provisions in the tax code that frankly we could change. But you wouldn’t change it because all of these people gave you the money so you can take negative ads on Donald Trump. … I understand the tax code better than anybody that’s ever run for president.”

Clinton: “Since the Great Recession, the gains have all gone to the top. And we need to reverse that. People like Donald who pay zero in taxes, zero for our vets, zero for our military, zero for health and education — that is wrong. And we’re going to make sure that nobody, no corporation and no individual can get away without paying his fair share to support our country.”

It’s easy to forget now, but before Friday’s video-tape scandal, the big revelation that rocked the campaign between the debates was the publication by The New York Times of documents suggesting that Trump might have paid no federal income taxes for as long as 18 years. Somewhat surprisingly, it was Trump who first raised the issue, claiming to “pay hundreds of millions of dollars in taxes.” Later on, however, he confirmed the substance of the Times’s reporting — that he had used a $916 million loss to avoid paying taxes — although he wouldn’t say for how many years.

Trump, as he has before, said that because he knows how to use the tax code to his advantage, he would also be in the best position to fix it. And he implied that he would raise taxes on the rich, stressing his proposal to eliminate the so-called “carried-interest loophole” that allows some wealthy Americans to pay lower taxes on certain kinds of income. But independent analyses, including those from conservative groups, find that other provisions in Trump’s tax plan would more than offset the closing of that loophole, and that overall the rich would pay less under his proposed policy. (Some middle-class families, meanwhile, would probably pay more.)

Clinton, unsurprisingly, seized on the Times’s revelations as evidence that the tax code is rigged in favor of the rich — something she said she’d worked to fix as a senator and would help change as president. An analysis of her tax plan from the Tax Policy Center, which is jointly run by the Urban Institute and the Brookings Institution, found that it would raise taxes by $1.1 trillion over the next decade, with essentially all of that coming from the richest 1 percent of Americans; the bottom 95 percent would see little change to their tax bills.

Clinton may have overstated things when she said that the gains during the recovery “have all gone to the top.” In 2015, according to the most recent data available, the biggest income gains were among those lower down the earnings spectrum.

Syria

Clinton: “I would not use American ground forces in Syria. I think that would be a very serious mistake. I don’t think American troops should be holding territory, which is what they would have to do as an occupying force. I don’t think that is a smart strategy. I do think the use of special forces, which we’re using, the use of enablers and trainers in Iraq, which has had some positive effects, are very much in our interests.”

Trump: “I think you have to knock out ISIS. Right now, Syria is fighting ISIS. We have people that want to fight both at the same time. … I believe we have to get ISIS. We have to worry about ISIS before we can get too much more involved. She had a chance to do something with Syria. They had a chance and that was the line. And she didn’t.”

Clinton is often criticized by liberals for being too hawkish on foreign policy, a criticism Trump has tried to stoke by claiming — falsely — to have himself opposed the Iraq war, which Clinton supported. (Clinton has since called her vote authorizing the war a “mistake.” There is no evidence that Trump spoke out against the war before it began.) On Sunday night, however, the difference between the candidates was less about how aggressive the U.S. should be and more about whom that aggression should be directed against.

Clinton ruled out using American ground forces in Syria, but she called for other forms of military action against both ISIS and the Syrian regime. In the case of ISIS, she called for the targeting of ISIS leader Abu Bakr al-Baghdadi, as well as for working more closely with Kurdish and Sunni opponents of ISIS. But she also called for a no-fly zone and a safe zone in Syria to protect civilians from the Russian-backed regime of Syrian president Bashar al-Assad and to give the U.S. “leverage” at the negotiating table. (How she would accomplish those goals without a major commitment of U.S. forces is unclear.)

Trump, for his part, explicitly broke with his running mate, Mike Pence, in saying the U.S. should focus on destroying ISIS rather than targeting the Assad regime. (“He and I haven’t spoken and I disagree,” Trump said of Pence.) Trump, who has previously praised Russian President Vladimir Putin and has often been accused of being too close to Russia, didn’t outright defend Russia’s Syria policy. But he did say that Russia and Syria are both “killing ISIS” while the U.S. does little. In fact, Russia and Syria have barely skirmished with ISIS.

Energy

Trump: “Energy is under siege by the Obama administration. Under absolutely siege. … The EPA is so restrictive that they are putting our energy companies out of business. And all you have to do is go to West Virginia or places like Ohio, which is phenomenal, or places like Pennsylvania, and you see what they are doing to the people. Miners and others in the energy business. It’s a disgrace. It’s an absolute disgrace.”

Clinton: “I support moving towards more clean, renewable energy as quickly as we can, because I think we can be the 21st-century clean energy superpower and create millions of new jobs and businesses. But I also want to be sure that we don’t leave people behind. … Those coal miners and their fathers and grandfathers, they dug that coal out, a lot of them lost their lives. They were injured. But they turned the lights on and they powered their factories. I don’t want to walk away from them.”

Trump and Clinton agree on one thing when it comes to energy: Coal miners are in trouble and need help. No surprise there: Coal country includes the crucial battleground states of Ohio and Pennsylvania. But Trump and Clinton disagree about why coal miners are in trouble and what to do about it — along with essentially everything else when it comes to energy.

Trump’s basic narrative on energy is simple: It’s the government’s fault. Restrictive environmental regulations are killing not just the coal industry but the oil and gas industry too. That’s partly correct when it comes to coal: Environmental regulations have hurt the industry, and Obama’s currently stalled Clean Power Plan, if enacted, would probably hurt it more. But the bigger factor has been the surge in natural-gas production, which has pushed down the price of natural gas and made coal less competitive.

Clinton is a villain in much of coal country for her comment at a town hall meeting last March that she was “going to put a lot of coal miners and coal companies out of business.” Clinton has since apologized for the comment, and she has cleaned up her messaging, but her policy remains the same: Faced with climate change, the U.S. should transition away from coal as quickly as possible, but the government should try to help those who lose jobs as a result. Clinton has a $30 billion “plan for revitalizing coal communities,” which includes reforming benefits for miners suffering from “black lung,” repurposing coal mine and power plant sites, and creating new tax credits to encourage private investment in communities that have lost coal-industry jobs. But her plan has been met with skepticism by many coal communities, and by many experts.